A number of important changes to BadgerCare take effect tomorrow, April 1.  At the top of the list are the following two changes:

• Cutting in half the income eligibility ceiling for parents and caretakers, as well as childless adults in BadgerCare Core, by reducing the income cap to the federal poverty level (from the current limit of 200% of FPL).
• Extending BadgerCare to all childless adults below the poverty level (in effect ending the waiting list for childless adults below that income limit), and moving about 16,000 childless adults now in BadgerCare Core into the regular BadgerCare plan, with its broader range of health care services.

However, there are also a number of other changes taking effect on April 1.  Although they have a much lower profile, several of these changes are quite important:

• Ending the option for unsubsidized BadgerCare coverage for children in families over 300% of the poverty level.
• Making children between 200% and 300% of the poverty level eligible for the full range of BadgerCare services, rather than the more limited range now offered in the BadgerCare Benchmark Plan.
• Implementing new federal standards for defining income and family size for purposes of determining BadgerCare eligibility (including changes such as no longer counting child support income, and more generous deductions for people who are self-employed).
• Making changes to Transitional Medical Assistance (TMA), including the expansion of premiums by applying them to parents between 100% and 133% of the poverty level, after they have been in TMA for 6 months.
• Authorizing qualified hospitals to start using new “presumptive eligibility” procedures for expediting the temporary enrollment of people who appear to be qualify for BadgerCare.

A total of roughly 75,000 people are expected to lose their BadgerCare coverage.  Those savings are being used to help finance the expansion of BadgerCare to an estimated 82,000 childless adults below the poverty level – rather than financing that expansion and spending substantially less state funding by using the enhanced federal funding provided for that purpose by the Affordable care Act.  Most of the people losing their BadgerCare coverage will be eligible for subsidized (but more costly) private coverage purchased through the new Marketplace.  Although they have until May 30 to sign up for a Marketplace plan, they need to sign up by 11:00 pm CT tonight to avoid a coverage gap in April.

A voluminous report issued today by the Dept. of Health Services (DHS) and Office of the Commissioner of Insurance (OCI) once again emphasizes Wisconsin’s “unique” approach to the Medicaid expansion issue.  As the Governor and other state officials like to point out, Wisconsin’s approach is unique because we are the only state that is expanding coverage for childless adults but not taking the enhanced federal funding.  That’s a valid point, but they don’t mention that another thing that makes the Wisconsin approach unique or exceptional is that we are eliminating Medicaid coverage for far more adults than any other state.

The new DHS and OCI report and appendices total 1,660 pages, so I strongly urge you not to download it and hit “print” without thinking carefully about how many trees and how much shelf space you are prepared to sacrifice.

Jon Peacock